Clinical and Experimental Gastroenterology最新文献

{"title":"Splenic Steatopathy: A Clinical and Experimental Framework for Lipid-Associated Splenic Pathology.","authors":"Vishal G Shelat","doi":"10.2147/CEG.S628370","DOIUrl":"https://doi.org/10.2147/CEG.S628370","url":null,"abstract":"<p><p>The spleen is usually viewed as a hematologic, vascular and immune organ, but rarely within lipid-associated disease. This review proposes splenic steatopathy as a provisional clinical and experimental framework rather than an established diagnosis or a splenic equivalent of fatty liver disease. Evidence is organized into pre-splenic drivers, intra-splenic pathology and post-splenic consequences. Upstream drivers include metabolic dysfunction-associated steatotic liver disease, obesity, severe hypertriglyceridemia, lysosomal storage disorders, drug-induced phospholipidosis, altered lymphatic lipid handling and portal-hemodynamic stress. Spleen-level findings include altered volume, attenuation, stiffness or metabolic activity; lipid-laden histiocytes; lysosomal or phospholipid storage; and immune-cell remodeling. Potential downstream relevance includes cytopenias, immune dysfunction, infection vulnerability, diagnostic redirection, cancer-associated immune biology and perioperative risk. Human evidence currently consists mainly of observational imaging studies and rare tissue reports; animal studies provide mechanistic support, while several proposed clinical links remain hypotheses. No validated diagnostic criteria, imaging thresholds or biomarkers currently exist. The framework may help distinguish unexplained splenomegaly from common mimics and, if validated, support long-term risk stratification for infection and malignancy in patients with metabolic liver disease. Future studies should prioritize spleen-specific imaging methods, tissue-imaging correlation, lipidomics, immune phenotyping and prospective outcome validation.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"628370"},"PeriodicalIF":2.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiome and Short-Chain Fatty Acid Alterations After Cardiopulmonary Bypass are Associated with Nutritional and Functional Impairment in Young Children with Congenital Heart Defects.","authors":"Shoira Abdusalamovna Agzamova, Faniya Rashidovna Babadjanova","doi":"10.2147/CEG.S600414","DOIUrl":"10.2147/CEG.S600414","url":null,"abstract":"<p><strong>Background: </strong>Cardiac surgery with cardiopulmonary bypass (CPB) in young children is associated with systemic stress, gastrointestinal dysfunction, and impaired nutritional recovery. The role of gut microbiome disruption and short-chain fatty acid (SCFA) metabolism in these processes remains insufficiently studied.</p><p><strong>Objective: </strong>To evaluate changes in gut microbiome composition, SCFA profiles, and nutritional status in children aged 0-3 years after CPB, and to assess their association with postoperative feeding intolerance and impaired growth.</p><p><strong>Methods: </strong>This prospective observational study included 20 children undergoing cardiac surgery with CPB. Stool samples were collected preoperatively and during the early postoperative period. Microbiota composition was assessed using culture-based microbiological methods, and fecal SCFA concentrations were measured by gas chromatography. Clinical, anthropometric, and laboratory parameters were assessed, and their associations with CPB characteristics and microbiome alterations were analyzed.</p><p><strong>Results: </strong>The postoperative period was characterized by significant intestinal dysbiosis, including reduced abundance of beneficial bacteria (Bifidobacterium, Lactobacillus, Bacteroides) and decreased SCFA-producing taxa. Fecal butyrate and propionate levels were significantly reduced. These changes were associated with increased intestinal inflammation, feeding intolerance, impaired nutrient absorption, and insufficient weight gain. The severity of dysbiosis correlated with CPB duration.</p><p><strong>Conclusion: </strong>CPB in early childhood is associated with disruption of gut microbiota and reduced SCFA production, which are linked to postoperative feeding intolerance and impaired nutritional recovery. Targeted monitoring and modulation of the gut microbiome may improve clinical outcomes in pediatric cardiac surgery patients.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"600414"},"PeriodicalIF":2.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irritable Bowel Syndrome Prevalence in Patients with Inflammatory Bowel Disease in Remission: Single-Center Experience.","authors":"Olga Golubovic, Tamara Knezevic Ivanovski, Djordje Kralj, Milos Mitrovic, Aleksandar Milić, Petar Svorcan, Srdjan Markovic","doi":"10.2147/CEG.S582517","DOIUrl":"10.2147/CEG.S582517","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBD) are characterized by features of abdominal pain and changes in bowel habits, making it hard to differentiate between the two. Early studies that estimated prevalence of IBS in IBD patients defined remission based only on clinical scores, potentially overestimating IBS symptoms and underestimating subclinical inflammation. The aim of this study was to determine prevalence of IBS in IBD patients who are treated with biologics and have reached clinical, biologic and endoscopic remission, thereby applying a more stringent definition of remission.</p><p><strong>Methods: </strong>This single-center cross-sectional study included 136 patients (68 patients with Crohn's disease and 68 with ulcerative colitis) who are treated with biologics from December 2022 to June 2023 and have reached clinical, biologic and endoscopic remission. Clinical remission was defined as Crohn's disease activity index (CDAI) ≤ 150 for patients with Crohn's disease (CD), and Mayo partial score ≤ 1 for patients with ulcerative colitis (UC). Biologic remission was defined as faecal calprotectin (FCP) ≤ 250 ug/g, and endoscopic remission was defined as the absence of ulcerations for CD and Mayo subscore ≤ 1 for UC patients. The presence of IBS was defined by Rome IV criteria.</p><p><strong>Results: </strong>A total of 28 (20.6%) patients in complete remission reported symptoms consistent with IBS, based on Rome IV criteria. The prevalence of IBS was higher in patients with Crohn's disease than in those with ulcerative colitis (CD 27.9% (19/68) vs UC 13.2% (9/68), <i>p</i> = 0.034). Females and smokers with Crohn's disease are more likely to report IBS symptoms.</p><p><strong>Conclusion: </strong>Prevalence of IBS symptoms in IBD patients varies according to how remission is defined. When using stringent clinical, biological and endoscopic remission criteria, 20% of patients present with IBS symptoms, more commonly in those with CD.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"582517"},"PeriodicalIF":2.6,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Review of the Patient Burden and Therapeutic Landscape of Irritable Bowel Syndrome with Constipation in the United States [Corrigendum].","authors":"","doi":"10.2147/CEG.S618800","DOIUrl":"https://doi.org/10.2147/CEG.S618800","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/CEG.S464375.].</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"618800"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Colorectal Signet Ring Cell Carcinoma and the Risk of Multiple Primary Gastrointestinal Malignancies: A Retrospective Cohort Based on SEER Database from 2000-2021.","authors":"Belal Mohamed Hamed, Asmaa Ellaithy, Alzahraa Faris Alesawy, Alhareth Alhusban, Nahla Ali, Bushra Al-Shaikh, Eslam Mohamed Elshennawy, Sally Ali Elbadry","doi":"10.2147/CEG.S588726","DOIUrl":"10.2147/CEG.S588726","url":null,"abstract":"<p><strong>Background: </strong>Signet-ring cell carcinoma (SRCC) is a rare subtype of colorectal cancer, constituting 0.5-2.5% of all adenocarcinomas. It is characterized by signet ring cells as the dominant malignant cell type. Developing gastrointestinal (GI) second primary malignancies (SPMs) after SRCC is a rare event reported in the literature and insufficiently addressed. This study aimed to explore this gap and provide updated evidence about this rare cancer.</p><p><strong>Methods: </strong>Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Standardized incidence ratio (SIR) analyses with multiple outcome assessment were performed, applying a two-month latency exclusion period to evaluate the risk of GI SPMs in patients diagnosed with primary colorectal SRCC. The SIR was calculated as observed/expected (O/E), with excess absolute risk (EAR) per 10,000. Significance was achieved at 0.05 with a 95% confidence interval (CI).</p><p><strong>Results: </strong>There was an increased risk for GI SPMs after SRCC in the 2-11 months interval (O/E=2.49, P<0.05, EAR=37.31), and over 10 years of follow-up (O/E=3.08, P<0.05, EAR=59.20). Small intestine SPMs in the 2-11 months interval had an O/E of 4.17 (P<0.05, 95% CI: 0.11-23.26, EAR=1.97), with an overall O/E of 9.62 (P<0.05, EAR=6.32). No events of GI SPMs were observed among young patients during follow-up (O/E=1.05, P>0.05, EAR=0.12). Young patients had lack of observed events for GI SPMs (O/E=0.00, EAR=-0.15), compared to middle-aged (O/E=7.66, P<0.05) and elderly patients (O/E=2.36, P<0.05). Patients received chemotherapy showed a slightly higher observed incidence of SPMs (O/E=2.39, P<0.05, EAR=49.29); however, this finding should be interpreted cautiously given known limitations of chemotherapy data within the SEER database.</p><p><strong>Conclusion: </strong>Patients diagnosed with colorectal SRCC are at a significantly increased risk of developing GI SPMs. Given the poor overall prognosis of colorectal SRCC, early surveillance protocols must be carefully contextualized at short intervals (6-12 months) for early detection of GI SPMs. However, a reduced intensity surveillance is recommended beyond 3-5 years to integrate prevention with long-term follow-up. Recommendations should be tailored according to patients' risk profiles with individualized patient focused programs.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"588726"},"PeriodicalIF":2.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Biological Effect of Oral Ginkgolic Acid Liposome Nanoparticles for Treating Refractory <i>Helicobacter pylori</i> Infection.","authors":"Jingwen Xu, Chengbo Zhang, Yan Jiang, Rumeng Wang, Yang Liu, Ning Zhang, Yugang Liu, Lizhou Jia","doi":"10.2147/CEG.S590424","DOIUrl":"10.2147/CEG.S590424","url":null,"abstract":"<p><strong>Objective: </strong>To explore the antibacterial effect of ginkgolic acid (GA) modified into liposome nanoparticles (TLM@GA) against <i>Helicobacter pylori</i> and investigate the antibacterial mechanism involved to provide a lead drug for radical clinical treatment.</p><p><strong>Methods: </strong>A new complex that improved GA stability and bioavailability was constructed using liposome nanoparticles (TLM@GA). The construction of the complex was verified by Fourier transform infrared spectroscopy, scanning electron microscopy, Zeta potential, and particle size detection, and its physicochemical properties were comprehensively evaluated. An acute gastritis model was also established using C57BL/6 mice, in which the in vivo therapeutic effect of TLM@GA was evaluated by detecting the colonization amount of the clinical multi-resistant strain HPBS001 in the gastric mucosa. Additionally, the pathological inflammation of the gastric mucosa was observed with H&E staining, apoptosis of gastric mucosal cells was observed with TUNEL staining, and the expression of serum inflammatory factors was detected with enzyme-linked immunosorbent assay. The in vivo safety of TLM@GA was evaluated by detecting its effect on mouse body weight and the damage to the stomach, liver, spleen, and kidneys.</p><p><strong>Results: </strong>The TLM@GA complex had excellent stability and dispersibility. The minimum inhibitory concentration of GA against <i>H. pylori</i> strains was 16-32 μg/mL, and that of TLM@GA was 0.25-0.5 μg/mL. After GA was modified into TLM@GA, its antibacterial activity was 32-128 times higher. After treatment with TLM@GA (28 mg/kg), the colonization of <i>H. pylori</i> in the gastric mucosa was significantly reduced, which was better than that in the omeprazole and amoxicillin (dual-therapy) and GA groups. Apoptotic and inflammatory cells in the gastric mucosa were significantly reduced, indicating alleviated inflammation. After treatment, the expression levels of major inflammatory factors were significantly decreased. There was no significant change in body weight when mice were intragastrically administered 140 mg/kg TLM@GA for 1 week, and no obvious pathological damage was found in the stomach, liver, spleen, or kidneys.</p><p><strong>Conclusion: </strong>TLM@GA had excellent stability, efficient release, and good loading capacity efficiency. It was significantly superior to GA in terms of in vitro antibacterial activity, had low toxicity, was not prone to drug resistance, and demonstrated high safety. TLM@GA demonstrated a good antibacterial effect in the in vivo acidic environment, effectively slowing the apoptosis of gastric mucosal cells and significantly reducing levels of inflammatory factors, alleviating the inflammatory response.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"590424"},"PeriodicalIF":2.6,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aimed at Subtype Discrimination but Yielding a Shared Marker: Integrative Analysis of Blood Transcriptomes Reveals Upregulated <i>TLR5</i> as a Potential Biomarker for IBD.","authors":"Arman Mokaram Doust Delkhah","doi":"10.2147/CEG.S584999","DOIUrl":"10.2147/CEG.S584999","url":null,"abstract":"<p><strong>Background: </strong>Despite the similarities, Crohn's disease (CD) and ulcerative colitis (UC), the two major subtypes of inflammatory bowel disease (IBD), exhibit distinctions. The increasing burden of IBD necessitates discovering novel diagnostic markers. Considering the importance of distinguishing between CD and UC in selecting therapeutic strategies in clinical settings, this investigation focused on identifying subtype-specific blood biomarkers.</p><p><strong>Methods: </strong>The discovery set was formed by integrating five blood transcriptomic datasets, including GSE119600, GSE126124, GSE94648, GSE86434, and GSE71730, which incorporated samples from CD, UC, and controls. After determining DEGs in CD and UC, they were separately filtered according to WGCNA and then analyzed by LASSO and RF algorithms. Eventually, ROC analysis of the diagnostic performances was conducted independently in the datasets used for discovery. Moreover, ROC analysis was implemented in independent cohorts to assess the generalizability of findings.</p><p><strong>Results: </strong>Initially, the identified subtype-specific candidate biomarkers included <i>INPPL1, TLR5, SLC9A8, IMPDH1</i>, and <i>GRK6</i> for CD, and <i>IL4R, ACAA1, NARF</i>, and <i>RRM2</i> for UC. However, external validation only accentuated the promising diagnostic potential of <i>TLR5</i> for CD. However, <i>TLR5</i> was nonspecific for CD and also acts as a potential biomarker for UC. While this study did not unveil subtype-specific diagnostic markers capable of stratifying CD from UC, the upregulated <i>TLR5</i> was identified as a shared biomarker for both subtypes.</p><p><strong>Conclusion: </strong>This integrative analysis of blood transcriptomes diverged from its initial purpose, the identification of subtype-specific biomarkers, and demonstrated that <i>TLR5</i> exhibits reproducible diagnostic efficacy for IBD.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"584999"},"PeriodicalIF":2.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network Pharmacology, Molecular Docking and Dynamics Simulation Reveal the Anti-Colitis Mechanism of <i>Smilax glabra</i> Roxb.","authors":"Yuan Cui, Jingyi Hu, Yanan Li, Yiheng Tong, Hong Shen","doi":"10.2147/CEG.S595836","DOIUrl":"10.2147/CEG.S595836","url":null,"abstract":"<p><strong>Purpose: </strong>A combination of bioinformatics methods including network pharmacology, molecular docking and molecular dynamics simulation was utilized to investigate the potential mechanism of <i>Smilax glabra</i> Roxb. (SG) in the treatment of ulcerative colitis (UC).</p><p><strong>Methods: </strong>We firstly used network pharmacology to screen out the major active components, targets and pathways. Secondly, the top 5 ingredients and the top 5 targets were docked with molecular docking technology respectively. Thirdly, the two protein-compound complexes with the lowest binding scores were subjected to molecular dynamics simulation (MDs).</p><p><strong>Results: </strong>A total of 15 bioactive compounds and 191 targets were identified, with the top 5 compounds being quercetin, beta-sitosterol, naringenin, stigmasterol and diosgenin, and the top 5 targets being AKT1, IL-6, TNF, TP53 and IL-1β. Predominant enrichment was observed in the PI3K-Akt signaling pathway, TNF signaling pathway, IL-17 signaling pathway, MAPK signaling pathway and apoptosis. Each set of molecular docking calculations was run 50 times and repeated 3 times for statistical analysis, with results showing that the majority of binding energies were less than -5 kcal/mol, indicating successful docking. Specifically, stigmasterol-TP53 (-9.10 ± 0.07 kcal/mol) and diosgenin-TP53 (-8.80 ± 0.73 kcal/mol) are the two complexes with the lowest binding energies for MDs. According to the MDs, the stig-masterol-TP53 and diosgenin-TP53 complex shows ideal conformational stability and interaction energy.</p><p><strong>Conclusion: </strong>Multiple components of SG may exert therapeutic effects on UC through multiple targets and various signaling pathways. Novelty of this study lies in linking SG compounds to UC-specific targets and confirming stable docking/MDs interactions with TP53. However, further validation through in vivo and in vitro experiments is required to provide reliable evidence for clinical application.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"595836"},"PeriodicalIF":2.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of In-Hospital Mortality in <i>Helicobacter pylori</i>-Negative, Non-Variceal Upper Gastrointestinal Bleeding: A Retrospective Cohort Study.","authors":"Giselle María Padilla Gutiérrez, Gregorio Jurado Delgado, Alex Domínguez-Vargas, Natalia Andrea Jurado Rua, Leonardo F Brochado Fontalvo, Henry J González-Torres","doi":"10.2147/CEG.S557604","DOIUrl":"10.2147/CEG.S557604","url":null,"abstract":"<p><strong>Purpose: </strong>With the global decline in <i>Helicobacter pylori</i> infection, upper gastrointestinal bleeding (UGIB) is increasingly driven by non-infectious, non-Nonsteroidal Anti-Inflammatory Drug (NSAID) mechanisms, particularly antithrombotic use and comorbidity-related mucosal injury. This study aimed to characterize the etiology, clinical profile, and in-hospital mortality predictors in patients with <i>H. pylori</i>-negative, non-variceal UGIB in a Colombian tertiary care setting.</p><p><strong>Patients and methods: </strong>We conducted a retrospective cohort study at a quaternary hospital in Barranquilla, Colombia, including all adults (≥18 years) hospitalized with endoscopically confirmed non-variceal UGIB and negative <i>H. pylori</i> testing (rapid urease test and/or histology). Clinical, endoscopic, and medication data were analyzed.</p><p><strong>Results: </strong>Of 285 patients, the median age was 60 years (IQR: 39-73), and 54% were male. NSAID use was rare (2.8%), whereas antithrombotic exposure was prevalent (28.8%), including low-dose aspirin (18.2%) and dual antiplatelet therapy (4.9%). The most common endoscopic findings were erosive gastropathy (45%) and ulcers (12%). Overall in-hospital mortality was 5% (n=13). In multivariable analysis, age >60 years (aOR: 2.9; 95% CI: 1.7-10.2; p = 0.05), cardiovascular complications (aOR: 7.8; 95% CI: 1.9-32.0; p = 0.004), encephalopathy (aOR: 8.5; 95% CI: 2.2-33.0; p = 0.009), and antiplatelet plus anticoagulant therapy (aOR: 5.3; 95% CI: 1.6-17.5; p = 0.006) were independently associated with in-hospital mortality.</p><p><strong>Conclusion: </strong>In this cohort, in-hospital mortality in non-variceal UGIB patients without <i>H. pylori</i> infection was associated with systemic factors such as advanced age, cardiovascular complications, encephalopathy, and antiplatelet-anticoagulant combination therapy rather than bleeding lesions. These findings support risk stratification based on comorbidities and medication use in this growing population.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"557604"},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal Prolapse as a Rare Presentation of Colorectal Cancer: Case Series and Clinical Perspectives.","authors":"Prapanca Nugraha, Kiki Lukman, Tommy Ruchimat, Alma Wijaya, Terri Sandi Susyanto","doi":"10.2147/CEG.S495002","DOIUrl":"10.2147/CEG.S495002","url":null,"abstract":"<p><strong>Background: </strong>Rectal prolapse is the protrusion of the rectum through the anal canal, commonly observed in older women with weakened pelvic floor muscles and anal sphincters. Clinical symptoms may include a painful, irreducible anal mass and rectal bleeding. Surgical intervention typically aims to restore normal anatomy through tumor resection and rectal fixation. The occurrence of colorectal cancer within rectal prolapse is rare and may present unique diagnostic and management challenges with distinct clinical implications.</p><p><strong>Case series: </strong>We present three cases of rectal prolapse associated with colorectal cancer. The patients (aged 40, 79, and 79), one female and two males presented with rectal prolapse. One patient was seen in the outpatient clinic, while the other two presented to the emergency department with painful, strangulated prolapse. All patients underwent tailored surgical resections. Histological analysis revealed adenocarcinomas ranging from pT1 to pT2, all with N0Mx staging, two located in the rectum and one in the descending colon. These cases highlight the importance of preoperative imaging in identifying occult malignancies, particularly in atypical presentations of rectal prolapse.</p><p><strong>Conclusion: </strong>Patients presenting with rectal prolapse, especially without predisposing factors, should be evaluated for underlying malignancy. Preoperative assessment is critical for identifying concomitant tumors and optimizing management to prevent recurrence and complications.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"19 ","pages":"495002"},"PeriodicalIF":2.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}